Savić M, Gvozdenović S, Krajnov J
Klinika za medicinsku rehabilitaciju, Klinicki centar Novi Sad.
Med Pregl. 2000 Jul-Aug;53(7-8):405-8.
Cerebrovascular insult causes focal damage of the central nervous system structures consequently causing loss or disturbance of their functions. Motor deficit is often associated with personality alterations generally speaking, as well as changes in behavior and loss of numerous neuropsychological functions. Rehabilitation of such patients should be defined by all members of the team, including the patient himself and members of his family.
This is a case report on a male patient 49 years of age with rightsided paralysis accompanied by aphasia. Thirty days after cerebrovascular insult he was transferred from the Clinic of Neurology in Novi Sad to the Clinic of Medical Rehabilitation. Functional disability assessment was made using Barthel Index, whereas communication was assessed by Boston Diagnostic Aphasia Examination. The rehabilitation program included, apart from the usual team, the patient himself and members of his family. The patient became the center of the team and was informed about the disease. Personal assessment of the patient on his functional and communication abilities and their importance for further progress was used to set the objectives of the rehabilitation program. The rehabilitation program was performed by a speech therapist and a psychologist, including kinesis, work activities, occupational therapy, individual and group therapy.
The outcome of the rehabilitation program in this patient was significantly better than expected.
This case report shows that being the center of the rehabilitation team the patient takes an active part in setting objectives of the rehabilitation program, whereas involvement of the family, knowledge on necessary medical issues about the disease, contribute to better motivation and better outcome of the rehabilitation program in patients with hemiplegia caused by cerebrovascular insult.
脑血管损伤会导致中枢神经系统结构的局灶性损害，从而引起其功能丧失或紊乱。一般来说，运动功能障碍常伴有人格改变、行为变化以及多种神经心理功能丧失。此类患者的康复应由团队所有成员共同确定，包括患者本人及其家庭成员。
这是一份关于一名49岁男性患者的病例报告，该患者右侧偏瘫并伴有失语症。脑血管损伤30天后，他从诺维萨德的神经病学诊所转至医学康复诊所。使用巴氏指数进行功能残疾评估，通过波士顿失语症诊断检查评估沟通能力。康复计划除了常规团队外，还包括患者本人及其家庭成员。患者成为团队的核心，并被告知病情。通过对患者功能和沟通能力及其对进一步康复的重要性进行个人评估，来设定康复计划的目标。康复计划由言语治疗师和心理学家执行，包括运动疗法、工作活动、职业治疗、个体治疗和团体治疗。
该患者康复计划的结果明显优于预期。
本病例报告表明，作为康复团队的核心，患者积极参与康复计划目标的设定，而家庭的参与以及对疾病必要医学问题的了解，有助于提高脑血管损伤所致偏瘫患者康复计划的积极性和康复效果。
